Fluoxetine - brand name list from Drugs.com Fluoxetine Important: The information below refers to medicines available in the United States that contain fluoxetine. Medications containing fluoxetine: → Search the entire Drugs.com site for fluoxetine Disclaimer: The indications, uses and warnings for individual medications outside the USA are determined by local regulatory bodies in each country or region. The Drugs.com website is intended primarily for audiences in the United States and its territories. Indications, uses and warnings on Drugs.com patient information leaflets are derived from FDA product labels and may differ in countries outside the USA. Every effort has been made to ensure that the information provided on this page is accurate, up-to-date and complete, but no guarantee is made to that effect. Drugs.com does not endorse drugs, diagnose patients or recommend specific therapies. The information on this page is not a substitute for the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that a drug or drug combination is safe, effective or appropriate for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of information provided here.

The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Always consult your doctor or healthcare specialist for medical advice. fluoxetine fluoxetine, Prozac, Sarafem: Facts about Side Effects Pharmacy Author: Omudhome Ogbru, PharmD Omudhome Ogbru, PharmD Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99. Medical and Pharmacy Editor: Jay W. Marks, MD Jay W. Marks, MD Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

GENERIC NAME: fluoxetine BRAND NAME: Prozac, Sarafem, Prozac Weekly DRUG CLASS AND MECHANISM: Fluoxetine is an oral drug that is used primarily for treating depression . It is in a class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that includes citalopram ( Celexa ), paroxetine ( Paxil ) and sertraline ( Zoloft ). Fluoxetine affects neurotransmitters, the chemicals that nerves within the brain use to communicate with each other. Neurotransmitters are manufactured and released by nerves and then travel and attach to nearby nerves. Thus, neurotransmitters can be thought of as the communication system of the brain. Serotonin is one neurotransmitter that is released by nerves in the brain. The serotonin either travels across the space between nerves and attaches to receptors on the surface of nearby nerves or it attaches to receptors on the surface of the nerve that produced it, to be taken up by the nerve and released again (a process referred to as re-uptake). Many experts believe that an imbalance among neurotransmitters is the cause of depression . Fluoxetine works by preventing the reuptake of one neurotransmitter, serotonin, by nerve cells after it has been released.

Since uptake is an important mechanism for removing released neurotransmitters and terminating their actions on adjacent nerves, the reduced uptake caused by fluoxetine increases free serotonin that stimulates nerve cells in the brain. The FDA approved Fluoxetine in December 1987. PRESCRIPTION: Yes GENERIC AVAILABLE: Yes PREPARATIONS: Capsules: 10, 20 and 40 mg. Capsules (delayed release): 90 mg. Tablets: 10, 20 and 60 mg. Oral suspension: 20 mg/5ml Fluoxetine (By mouth) - National Library of Medicine - PubMed Health Treats depression , obsessive-compulsive disorder (OCD), bulimia nervosa, and panic disorder . This medicine is an SSRI. Drug classes Antidepressant, Central Nervous System Agent ( About this - PubMed Health ) Uses Uses of This Medicine Fluoxetine is used to treat depression , obsessive-compulsive disorder (OCD), bulimia nervosa, premenstrual dysphoric disorder (PMDD), and panic disorder . It is also used together with olanzapine to treat depression that is part of bipolar disorder .

Fluoxetine is an antidepressant and belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). This medicine works by increasing the activity of a chemical called serotonin in the brain . This medicine is available only with your doctor's prescription. How To Use Capsule, Delayed Release Capsule, Liquid, Tablet Take your medicine as directed. Your dose may need to be changed several times to find what works best for you. Take your medicine at the same time each day. You may need to take this medicine for a month or longer before you feel better. If you feel that the medicine is not working well, do not take more than your normal dose. Tell your doctor. Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup. Delayed-release capsule: Swallow whole. Do not crush, break, or chew the capsule. This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one. Missed dose: Every day dose (Prozac® or Sarafem®): If you miss a dose or forget to take your medicine, take it as soon as you can.

If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose. Once-a-week dose (Prozac® Weekly™): If you miss a dose or forget to take your medicine, take it as soon as you can. Then go back to your regular schedule the next week. Do not use extra medicine to make up for a missed dose. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Drugs and Foods to Avoid Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins , and herbal products. Do not use this medicine together with pimozide or thioridazine . Do not use this medicine within 14 days of using an MAO inhibitor (MAOI), and do not start an MAOI for at least 5 weeks after you stop using fluoxetine . Some foods and medicines can affect how fluoxetine works.

Tell your doctor if you are using any of the following: Other medicine to treat depression , medicine to treat migraine headaches , medicine to treat mental illness, an antibiotic, medicine for seizures (such as carbamazepine , phenytoin ), a diuretic ( water pill ), medicine for heart rhythm problems, an NSAID pain or arthritis medicine (such as aspirin , celecoxib , diclofenac , ibuprofen , naproxen ), or a blood thinner (such as warfarin ) Do not drink alcohol while you are using this medicine. Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol. When Not To Use This medicine is not right for everyone. Do not use it if you had an allergic reaction to fluoxetine . Warnings Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease , liver disease, bleeding problems, diabetes , or a history of seizures . Tell your doctor if you have had heart disease, a heart rhythm problem (such as QT prolongation), heart attack , heart failure , low blood pressure , or a stroke . For some children, teenagers, and young adults, this medicine may increase mental or emotional problems.

This may lead to thoughts of suicide and violence. Talk with your doctor right away if you have any thoughts or behavior changes that concern you. Tell your doctor if you or anyone in your family has a history of bipolar disorder or suicide attempts. This medicine may cause the following problems: Serotonin syndrome (may be life-threatening when used with certain other medicines) Higher risk of bleeding Heart rhythm changes Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely. This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Keep all medicine out of the reach of children. Never share your medicine with anyone. Possible side effects Summary More details Call your doctor right away if you notice any of these side effects: Allergic reaction: Itching or hives , swelling in your face or hands , swelling or tingling in your mouth or throat , chest tightness, trouble breathing Prozac (Fluoxetine Hcl) Patient Information: Side Effects and Drug Images at RxList Where can I get more information? What is fluoxetine (Prozac)? Fluoxetine is a selective serotonin reuptake inhibitors (SSRI) antidepressant.

Fluoxetine affects chemicals in the brain that may become unbalanced and cause depression, panic, anxiety, or obsessive-compulsive symptoms. Fluoxetine is used to treat major depressive disorder, bulimia nervosa (an eating disorder) obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorder (PMDD). Fluoxetine is sometimes used together with another medication called olanzapine (Zyprexa) to treat depression caused by bipolar disorder (manic depression). This combination is also used to treat depression after at least 2 other medications have been tried without successful treatment of symptoms. Fluoxetine may also be used for purposes not listed in this medication guide. Fluoxetine 10 mg Cap-BAR blue/pink, imprinted with 93 7226 What are the possible side effects of fluoxetine (Prozac)? Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have a serious side effect such as: very stiff (rigid) muscles, high fever, sweating, fast or uneven heartbeats, tremors, overactive reflexes; nausea, vomiting, diarrhea, loss of appetite, feeling unsteady, loss of coordination; headache, trouble concentrating, memory problems, weakness, confusion, hallucinations, fainting, seizure, shallow breathing or breathing that stops; or severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. Less serious side effects may include: cold symptoms such as stuffy nose, sneezing, sore throat; drowsiness, dizziness, feeling nervous; decreased sex drive, impotence, or difficulty having an orgasm; or dry mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Learn More » What is the most important information I should know about fluoxetine (Prozac)? Do not take fluoxetine together with pimozide (Orap), thioridazine (Mellaril), or a monoamine oxidase inhibitor (MAOI) such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate). A dangerous drug interaction could occur, leading to serious side effects. You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Tell your doctor right away if you become pregnant while taking this medication. Fluoxetine may cause heart defects or serious lung problems in a newborn if you take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant. Do not start or stop taking fluoxetine during pregnancy without your doctor's advice. Side Effects Centers Prozac - Antidepressant with Serious Side Effects Prozac Did you know this version of Internet Explorer is out of date? To get the latest experience from our website, please upgrade your browser . Have a drug or medical device concern? call Prozac is an SSRI antidepressant manufactured by Eli Lilly. The drug is linked to birth defects when taken during pregnancy. Tell Us What You Think Please provide us any comments, suggestions, or feedback on how we can improve our website. Email (optional) Thank You! Thank you for filling out our customer survey.

We greatly appreciate all the feedback you've provided! If you would like to provide us any additional feedback, please feel free to contact us at [email protected] Depression is one of the most common mental disorders in the United States, and pharmaceutical companies have responded with an ever-growing arsenal of antidepressants. But along with the increasing use and effectiveness of antidepressant drugs, many health care professionals have raised concerns over the adverse side effects and serious complications associated with their use. There are many different classes of antidepressant medications. The current standard of treatment involves a drug class known as selective serotonin reuptake inhibitors (SSRIs). Scientists believe that depression can be triggered by a lack of the chemical serotonin, and these drugs essentially maintain higher levels of serotonin in the brain to correct the issue. Fluoxetine, the first SSRI, was discovered by chemists Klaus Schmiegel and Bryan Molloy while they worked for the pharmaceutical company Eli Lilly. Lilly won FDA approval for the drug in December 1987 and it was marketed as Prozac soon after.

Since that time, many other SSRIs have come on the market, including Citalopram (Celexa, Cipramil), Escitalopram (Lexapro, Cipralex, Seroplex, Lexamil), Fluvoxamine (Luvox), Paroxetine (Paxil, Aropax), Sertraline (Zoloft) and Vilazodone (Viibryd). Despite the competition, Prozac and its generic equivalents remain popular and have become the third-most-prescribed antidepressant in the United States. In 2010, more than 24.4 million prescriptions for generic fluoxetine were filled in the U.S. In addition to adult depression, the U.S. Food and Drug Administration (FDA) approved Prozac for the treatment of pediatric depression, obsessive-compulsive disorder, bulimia nervosa, panic disorder and premenstrual dysphoric disorder. Overuse of Prozac and Common Side Effects Researchers continue to study Prozac’s effects on the body, and new information about potential complications is still coming to light. One of the biggest concerns is that the drug is over-prescribed, unnecessarily subjecting patients to adverse side effects and possible withdrawal symptoms.

Patients taking Prozac may experience a host of side effects, including sexual dysfunction, dry mouth, nausea, headache, diarrhea, nervousness, restlessness, agitation, increased sweating, weight gain, insomnia and drowsiness. Although antidepressants like Prozac are not technically considered to be addictive, at least in the sense of inducing cravings in patients, doctors say they do make users dependent. Drug dependency means that the body has adapted to a chemical to the point that it requires steady doses to normally function. Because of this, patients who abruptly stop taking antidepressant drugs are likely to experience withdrawal symptoms such as nausea, headache, dizziness and lethargy. Patients are warned to wean themselves off antidepressants slowly and under a doctor’s care. High doses of SSRIs often increase the severity of side effects, and one particular side effect can be fatal. The onset of Serotonin Syndrome, a condition in which too much of the mood elevator is present in the brain, can occur within minutes, producing high blood pressure, hyperthermia, high body temperature and an increased heart rate that can lead to shock. Serotonin Syndrome can arise when SSRIs act alone or in conjunction with other medications .

Prozac Suicide Warning Prozac is one of the few antidepressants approved for the treatment of depression in youths. Unfortunately, however, studies on children have linked the drug to increased suicidal thoughts and behavior. As a result, the FDA issued a public warning in October 2004, and two years later extended the advisory to include young adults as old as 24. In 2007, the FDA took an even stronger stance. The agency required antidepressant manufacturers to update existing black-box warnings about the increased risks of suicidal thoughts and behavior during initial treatment, which the FDA defined as the first one to two months. An FDA black-box warning is the most stringent precaution a drug can carry before it is pulled from the shelves. It takes its name from the black border that surrounds the warning information on the drug’s packaging. The agency often requires pharmaceutical companies to include a bold warning on drug packaging and patient instruction sheets if serious or life-threatening risks are associated with the drug’s use.

Prozac and Pregnancy Pregnant women managing their depression with Prozac often face a difficult decision – either grapple with the potential dangers to mother and child if the depression is left untreated during pregnancy or continue taking the drug knowing there is a low but possible risk of harming their unborn children. SSRIs have largely been assigned a “C” grade for safety during pregnancy by the FDA. Drugs in this category have been known to harm animals in large doses, but the effects on unborn humans are not proven. When taken during the last half of pregnancy, some research links Prozac to a rare but serious lung problem known as persistent pulmonary hypertension of the newborn (PPHN). This condition arises when a newborn’s circulatory system does not properly adapt to breathing outside of the womb. According to the National Institute of Mental Health, a study of pregnant women published in 2009 found that the use of certain antidepressant medications may also increase the risk for premature birth. Heart defects of the septum have also been reported in newborns. Researchers are not only investigating physical birth defects that SSRIs have on fetuses, but the long-term neurological effects as well.

In July 2011, a case study from the Archives of General Psychiatry linked the use of SSRIs during the first trimester of pregnancy to an increased risk of the baby developing an autism spectrum disorder (ASD). In response to these and other studies, the FDA issued a December 2011 advisory stating that, “There are no adequate and well-controlled studies of SSRIs in pregnant women .” Patients are encouraged to speak with their doctors and carefully consider whether taking Prozac is in their best interest. SSRI antidepressants certainly have an important role in treating depression, but their use does not come without risks. It’s up to the individual to learn as much as possible about Prozac and make an informed decision. What is Prozac (fluoxetine)? What are the side effects of Prozac? - Medical News Today What is Prozac (fluoxetine)? What are the side effects of Prozac? Written by Joseph Nordqvist 40 Prozac (fluoxetine) is an antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) class of drugs. Prozac is mainly used for the treatment of major depression, obsessive-compulsive disorder, and panic disorder.

The medication was first introduced to the American market by Eli Lilly in 1988. Within a few years of being approved by the Food and Drug Administration (FDA), Prozac became one of the most widely prescribed antidepressants in the country. It works by blocking the absorption of the neurotransmitter serotonin in the brain. Regulating the amount of serotonin helps brain cells transmit messages to each other, resulting in a better and more stable mood. Prozac is commonly prescribed on its own, but can also be used combination with olanzapine (Zyprexa) to treat manic depression for patients with bipolar disorder; fluoxetine combined with olanzapine is known as Symbyax.1 Even though there are newer SSRIs like sertraline and citalopram, Prozac is still one of the most popular antidepressants available. The drug is available as a liquid, tablet, capsule, and as a delayed-release (long-acting) capsule. Contents of this article: Prozac - the pill that completely "revolutionized" the treatment of depression Prozac treatment results in more neurons being present in a region of the brain called the "dentate gyrus" (part of the hippocampal formation).

The medication specifically stimulates the generation of cells called amplifying neural progenitors - the second step in the neurogenesis pathway from stem cells to mature neurons.2 Neurogenesis means the growth and development of nervous tissue. The FDA currently approves Prozac for acute and maintenance treatment of major depressive disorder (MDD), obsessive compulsive disorder (OCD), bulimia nervosa, and panic disorder (with or without agoraphobia ).3 Prozac and olanzapine in combination is approved for acute treatment of depressive episodes associated with bipolar I disorder and treatment-resistant depression. Some doctors may prescribe Prozac "off-label" for the treatment of anxiety , premature ejaculation , obesity , and binge-eating disorder . Depression Prozac's efficacy in the treatment of depression is well established. A 6-week-long placebo-controlled trial involving depressed adults demonstrated that Prozac was significantly more effective at treating depression than placebo , as measured by the Hamilton Depression Rating Scale (HAM-D). The medication has also shown promising results in treating children and adolescents with depression.

One study, published in Archives of General Psychiatry, included 96 children and teenagers with depression (aged 7-17 years) who were either given a daily dose of 20 mg of fluoxetine or placebo for 8 consecutive weeks. The results showed that "fluoxetine was superior to placebo in the acute phase treatment of major depressive disorder in child and adolescent outpatients with severe, persistent depression."4 Some studies suggest that Prozac may not be the most effective antidepressant. Research published in the Cochrane Library, which compared the effectiveness of Prozac to other antidepressants, showed that Effexor (venlafaxine) and Zoloft (sertraline) were slightly better at treating major depressive disorder.5 However, Prozac can work well for patients who don't respond to other antidepressants. Researchers reported in Progress in Neuro-Psychopharmacology and Biological Psychiatry that depressive patients who fail to respond to treatment with the SSRIs paroxetine (Paxil) and citalopram (Celexa) - because of a certain genetic variation - may benefit from a switch to Prozac.6 Panic disorder SSRIs are very useful at treating anxiety-related illnesses, including panic disorder.

SSRIs are usually the first choice of medication intervention for panic disorder. A study published in the Journal of Psychiatry and Neuroscience revealed that of 30 patients diagnosed with panic disorder who received treatment with Prozac "thirty-two percent had zero panic attacks by week 3" and "by the end of eight weeks of treatment, 48% of the patients had zero panic attacks." There was a "significant reduction in anxiety and phobic avoidance and panic attacks."7 Obsessive-compulsive disorder (OCD) Typically, SSRIs need to be taken for more than 11 weeks before individuals with OCD start to feel any benefits. In most cases patients with OCD will be put on an SSRI such as Prozac for at least a year.

A 13-week placebo-controlled study, published in the Journal of the American Academy of Child and Adolescent Psychiatry, evaluated the "efficacy and tolerability of fluoxetine in the acute treatment of child and adolescent OCD" and concluded that "fluoxetine 20 to 60 mg daily was effective and well tolerated for treatment of OCD in this pediatric population."8 Bulimia nervosa Researchers reported in The American Journal of Psychiatry that for patients with bulimia nervosa who had not responded to psychological treatment, fluoxetine may be a useful intervention.9 Video - a brief animation of how Prozac works Side effects The FDA requires Prozac to come with a black box warning stating that antidepressants may increase the risk of suicide in people younger than 25. One of the most common side effects of Prozac is sexual dysfunction. Many patients report that after taking Prozac their overall interest in sex decreases and they begin to have difficulty not only in becoming aroused but also achieving orgasm.

The side effects of Prozac include: Decreased libido Asthenia (lack of bodily strength) Rash Vasodilatation (widening of blood vessels) According to Eli Lilly, Prozac should not be taken together with:10 Monoamine Oxidase Inhibitors (MAOIs): Pimozide and Thioridazine Drugs Metabolized by CYP2D6: Fluoxetine is a potent inhibitor of CYP2D6 enzyme pathway. Tricyclic Antidepressants (TCAs) Caution should be taken when used with drugs that affect the central nervous system , such as those belonging to the "benzodiazepines" class of drugs. Women who are pregnant should only take Prozac if the potential benefits outweigh the possible risks to the fetus (increasing the risk of poor neonatal adaptation). Breastfeeding whilst on the medication is not advised as fluoxetine can pass into the milk. Discontinuation and withdrawal Patients who suddenly stop taking Prozac (or reduce their dose) may experience brain zaps, dizziness, confusion, nightmares, vertigo , insomnia, nausea, and tremor. Abrupt discontinuation of Prozac can also lead to SSRI withdrawal syndrome.

According to a paper, published in the Journal of Clinical Psychiatry, titled "Serotonin reuptake inhibitor discontinuation syndrome: a hypothetical definition. Discontinuation Consensus panel":11 "SSRI discontinuation symptoms... may emerge when an SSRI is abruptly discontinued, when doses are missed, and less frequently, during dosage reduction. In addition, the symptoms are not attributable to any other cause and can be reversed when the original agent is reinstituted, or one that is pharmacologically similar is substituted. SSRI discontinuation symptoms, in most cases, may be minimized by slowly tapering antidepressant therapy, but there have been several case reports where symptoms occurred consistently even through repeated attempts to taper therapy. Physical symptoms include problems with balance, gastrointestinal and flu-like symptoms, and sensory and sleep disturbances. Psychological symptoms include anxiety and/or agitation, crying spells, irritability and aggressiveness." Written by Joseph Nordqvist Click the stars to rate this article What is Prozac (fluoxetine)? What are the side effects of Prozac? Public / Patient Fluoxetine(PIM 651) The safety of fluoxetine during pregnancy and lactation is not established (see section 7.4).

9.5 Other Several cases of fluoxetine withdrawal syndrome have been described, occurring from one to seven days after discontinuation of the medication. Symptoms included vertigo, dizziness, light-headedness, irritability, anxiety, headache, sweating, and nausea (Einbinder, 1995; Berlin, 1996). 9.6 Summary 10. MANAGEMENT 10.1 General principles The primary management of isolated fluoxetine overdose consists of institution of appropriate observation and supportive care. In most cases, this consists of no more than careful observation of vital signs and neurological status until signs and symptoms resolve. Intravenous access should be established as soon as practicable. In more severe intoxications or where there is a co-ingestion, more aggressive measures such as establishment of an airway, ventilation, administration of intravenous fluids, control of seizures, and control of hyperthermia may be necessary. 10.2 Life supportive procedures and symptomatic/specific treatment Intensive supportive care is rarely required.

Measures that may occcasionally be required are: endotracheal intubation and/or artificial ventilation if coma is present, intravenous fluid resuscitation if hypotension is present, control of seizures, cooling if hyperthermia is present (refer to appropriate treatment guides for more detailed management guidance). 10.3 Decontamination Gastrointestinal decontamination by administration of a single dose of oral activated charcoal may be indicated following ingestion of more than 800 mg of fluoxetine by an adult presenting within two hours, or where there has been a significant co-ingestion. 10.4 Enhanced elimination There are no effective methods known to enhance the elimination of fluoxetine. 10.5 Antidote treatment 10.5.1 Adults No data available. No data available. 10.6 Management discussion Although of theoretical benefit, the role of dantrolene in the management of the serotonergic syndrome has yet to be evaluated. 11. ILLUSTRATIVE CASES 11.1 Case reports from literature A 15-year-old female ingested forty five 20 mg fluoxetine tablets. Ten hours later, she was found jerking, frothing at the mouth and with a staring gaze.

On arrival at hospital thirty minutes later, she had a normal level of consciousness. She denied the ingestion of any other medications and had no previous history of seizures or trauma. Physical examination and all routine laboratory studies were unremarkable. Comprehensive drug screening did not detect the presence of any other substances. Serum fluoxetine and norfluoxetine concentrations were 1956 ng/mL and 416 ng/mL respectively (Braitberg & Curry, 1995). A 4-year-old child ingested 43 mg/kg of fluoxetine. Toxic effects consisted of a brief period of unresponsiveness, sinus tachycardia and moderate psychomotor agitation and dyskinesia. The child recovered completely with supportive care (Feierabend, 1995). A 40-year-old female developed a classical serotoninergic syndrome with severe hyperthermia (43ï¿½C) eight hours after ingesting 340 mg fluoxetine, 6000 mg moclobemide, 300 mg clomipramine and 12 mg clonazepam.

She died from the subsequent complications of fulminant disseminated intravascular coagulation and multiple organ failure (Power et al., 1995). A patient being treated with carbamazepine 200 mg/day for an affective disorder, developed a serotonergic syndrome 14 days following institution of fluoxetine therapy at a dose of 20 mg/day. In addition to features of the serotonergic syndrome, she reported dizziness, experienced an oculogyric crisis, and developed leucopenia and thrombocytopenia. She made a complete recovery within 72 hours of the discontinuation of fluoxetine (Dursun et al., 1993). 12. ADDITIONAL INFORMATION 12.1 Specific preventive measures 12.2 Other 13. REFERENCES Alderman CP, Moritz CK, & Ben-Tovim DI (1992) Abnormal platelet aggregation associated with fluoxetine therapy. Ann Pharmacotherapy, 26: 1517-1519. Aranth J & Lindberg C (1992) Bleeding as a side effect of fluoxetine.

Am J Psychiatry, 149: 412. Baldwin D, Fineberg N, & Montgomery S (1991) Fluoxetine, fluvoxamine and extrapyramidal tract disorders. Int Clin Psychopharmacol, 6: 51-58. Bass SP & Colebatch HJH (1992) Fluoxetine-induced lung damage. Med J Austral, 156: 364. Berlin C (1996) Fluoxetine withdrawal symptoms. J Clin Psychiatry, 57, (2): 93-94. Bobichon R, Bernard G, & Mion F (1993) [Acute hepatitis during treatment with fluoxetine]. Gastroenterologie Clinique et Biologique, 17 (5): 406-7 (in French). Borys D, Setzer S, Ling L, Reisdorf J, Day L, & Krenzelok E (1990) The effects of fluoxetine in the overdose patient. Clin Toxicol, 28 (3): 331-340.

Braitberg G & Curry SC (1995) Seizure after isolated fluoxetine overdose. Ann Emerg Med, Aug; 26 (2): 234-7. Burch KJ & Wells BG (1992) Fluoxetine/norfluoxetine concentrations in human milk. Pediatrics, 98: 676-677. Castiella A & Arenas J (1994) Fluoxetine hepatotoxicity. Am J Gastroenterology, 89 (3): 458-9. Crundwell JK (1993) Fluoxetine and suicidal ideation-a review of the literature. [review] Int J Neurosci, 68 (1-2): 73-84. Dista Laboratoires (1989) Prozac 20 mg. Manufacturer information. 92213 Saint Cloud, France. Dixit V, Nguyen H & Dixit YM (1991) Solid-phase extraction of fluoxetine and norfluoxetine from serum with gas chromatography-electron capture detection. J Chromatogr, 563: 379-384.

Dursun S, Mathew V, & Reveley M (1993) Toxic serotonin syndrome after fluoxetine plus carbamazepine. Lancet, 342: 442-3. Einbinder E (1995) Fluoxetine withdrawal. Amer J Psychiatry, 152, (8): 1235. Eisenhauer G & Jermain DM (1993) Fluoxetine and tics in an adolescent. Annals of Pharmacotherapy, 27 (6): 725-6. Ellison J, Milofsky J, & Ely E (1990) Fluoxetine-induced bradycardia and syncope in two patients. J Clin Psychiatry, 51: 385-386. Feder R (1991) Bradycardia and syncope induced by fluoxetine. J Clin Psychiatry, 52: 139. Feierabend R (1995) Benign course in a child with a massive fluoxetine overdose. J Fam Pract, 41 (3): 289-291.

Fontanille P, Jourdil N, Villier C & Bessard G (1997) Direct analysis of fluoxetine and norfluoxetine in plasma by gas chromatography with nitrogen-phosphorus detection. J Chromatogr, 692: 337-343. Gaufberg E & Ellison JM (1995) Photosensitivity reaction to fluoxetine. J Clin Psychiatry, 56, (10): 486. Geller DA, Biederman J, Reed ED, Spencer T, & Wilens TE (1995) Similarities in response to fluoxetine in the treatment of children and adolescents with obsessive-compulsive disorder. J Amer Acad Child Adol. Psychiatry, 34 (1): 36-44. Gupta R, Parker G, Norman T, Judd F, & Burrows G (1993) Fluoxetine-delayed half-life and an adverse event. Med J Australia, 158: 722-723. Guthrie S & Grunhaus L (1990) Fluoxetine-induced stuttering.

J Clin Psychiatry, 51: 85. Hemlock C, Rosenthal J, & Winston A (1992) Fluoxetine-induced psoriasis. Ann Pharmacother, 26: 211-212. Humphries J, Wheby M, & Vanden Berg S (1990) Fluoxetine and the bleeding time. Arch Path Lab Med, 114: 727-728. Jackson TW & Hornfeldt C (1991) Seizure activity following recreational LSD use in patients treated with lithium and fluoxetine (abstract). Vet Hum Toxicol, 33: 387. Kim SW & Pentel P (1989) Flu-like symptoms associated with fluoxetine overdose: a case report. J Toxicol Clin Toxicol, 27: 389-393. Kincaid R, Mc Mullin M, Crookham S, & Reiders F (1990) Report of a fluoxetine fatality. J Anal Toxicol, 14: 327-329.

Lane R, Baldwin D, & Preskorn S (1995) The SSRIs: Advantages, disadvantages and differences. J Psychopharmacol, 9/2 suppl, 163-178. Measom M (1992) Penile anesthesia and fluoxetine. Am J Psychiatry, 149: 709. Messiha F (1993) Fluoxetine: adverse effects and drug-drug-interactions. Clin Toxicol, 31 (4): 603-630. Modell JG (1989) Repeated observations of yawning, clitoral engorgement, and orgasm associated with fluoxetine administration. J Clin Psychopharmacol, 9: 63-65. Morris PLP (1991) Fluoxetine and orgasmic sexual experiences. Int J Psychiatry Med, 21: 379-389. Murray V (1995) Laryngeal dystonia. Br J Psychiatry, 167 (5): 698-9.

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Tueth MJ (1994) Revisiting fluoxetine (Prozac) and suicidal preoccupations. J Emerg Med, 12 (5): 685-687. Vidal (1996), 72th ed. Paris. 14. AUTHOR(S), REVIEWER(S), DATE(S) (INCLUDING UPDATES), COMPLETE ADDRESS(ES) Author: M.O. Rambourg Schepens, Prozac oral : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - WebMD Side Effects See also Warning section. Nausea , drowsiness, dizziness , anxiety, trouble sleeping, loss of appetite, tiredness, sweating , or yawning may occur. If any of these effects persist or worsen, tell your doctor promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: unusual or severe mental/mood changes (such as agitation, unusual high energy/excitement, thoughts of suicide), easy bruising/bleeding, muscle weakness /spasm, shakiness (tremor), decreased interest in sex , changes in sexual ability, unusual weight loss . Get medical help right away if you have any very serious side effects, including: bloody/black/tarry stools, vomit that looks like coffee grounds, fast/ irregular heartbeat , fainting , seizures , signs of kidney problems (such as change in the amount of urine), eye pain /swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night, blurred vision ). If you have diabetes, fluoxetine may affect your blood sugar levels . Monitor your blood sugar regularly and share the results with your doctor. Your doctor may need to adjust your medication, diet, and exercise when you start or stop fluoxetine. This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section).

Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness. Rarely, males may have a painful or prolonged erection lasting 4 or more hours. If this occurs, stop using this drug and get medical help right away, or permanent problems could occur. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. List Prozac side effects by likelihood and severity.

Precautions Before taking fluoxetine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of bipolar/manic-depressive disorder, personal or family history of suicide attempts, liver problems, diabetes, low sodium in the blood (such as may occur while taking "water pills" - diuretics), severe loss of body water (dehydration), seizures, stomach/intestinal ulcers, personal or family history of glaucoma (angle-closure type). This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages. Fluoxetine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using fluoxetine, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death). Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using this medication safely. The liquid form of this medication contains alcohol. Caution is advised if you have diabetes, alcohol dependence, or liver disease. Some medications (such as metronidazole, disulfiram) can cause a serious reaction when combined with alcohol. Ask your doctor or pharmacist about using this product safely. Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially bleeding and QT prolongation (see above). Older adults may also be more likely to develop low sodium in the blood, especially if they are taking "water pills" (diuretics). During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly. Since untreated mental/mood problems (such as depression, panic attacks, obsessive compulsive disorder) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss the benefits and risks of using this medication during pregnancy with your doctor. This drug may pass into breast milk and could have undesirable effects on a nursing infant. Consult your doctor before breast-feeding. What should I know regarding pregnancy, nursing and administering Prozac to children or the elderly?

Interactions Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Fluoxetine can stay in your body for many weeks after your last dose and may interact with many other medications. Before using any medication, tell your doctor or pharmacist if you have taken fluoxetine in the previous 5 weeks. Some products that may interact with this drug include: drugs removed from your body by certain liver enzymes including carbamazepine, vinblastine, antiarrhythmics such as propafenone/flecainide, tricyclic antidepressants such as desipramine/imipramine, other drugs that can cause bleeding/bruising including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen, "blood thinners" such as warfarin. Taking MAO inhibitors with his medication may cause a serious (possibly fatal) drug interaction.

Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for 2 weeks before and at least 5 weeks after treatment with this medication. Ask your doctor when to start or stop taking this medication. Many drugs besides fluoxetine may affect the heart rhythm (QT prolongation), including pimozide and thioridazine, among others. Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St.

John's wort, certain antidepressants (including other SSRIs such as citalopram/paroxetine, SNRIs such as duloxetine/venlafaxine), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs. Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine). Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely. This medication may interfere with certain medical/laboratory tests (including brain scan for Parkinson's disease), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug. Does Prozac interact with other medications?

Overdose If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness, fainting. Notes Do not share this medication with others. Keep all regular medical and psychiatric appointments. Missed Dose If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up. Storage Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product. Information last revised August 2016.

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Question: What is the most common trade name of the drug Fluoxetine?
Answer: Prozac